The Environmental and Occupational Medicine Academic Award will give Howard Kipen, MD, MPH and UMDNJ-Robert Wood Johnson Medical School the resources to substantially enlarge the scope of the school's Clinical Prevention Theme. The overall goal is sustained improvement in the RWJMS curriculum and in the capability of RWJMS trainees with respect to Environmental and Occupational (E/O) issues. We aim to enhance their recognition, diagnosis and management capabilities for environmental and occupational disease. Opportunities for prevention will ensue from accurate recognition of E/O diseases and risks. A videotape based E/O history taking course will be completed. Second year medical students will repeatedly practice and learn E/O history taking skills during their second year physical diagnosis course. Third year clerks in Internal Medicine will be required to perform E/O histories on patients and will take simulated patient exams based on E/O disease histories. Housestaff and students will be taught to defined list of conditions which require a thorough E/O history, and Internal Medicine and Family Practice resident's charts will be specifically reviewed for the presence and adequacy of the histories. Extensive feedback and consultation with Dr. Kipen will be built upon these chart reviews. An expanded E/O consultation service will evolve out of anticipated increased recognition of E/O exposures and diseases. Further initiatives with other Departments such as Pediatrics and Obstetrics and Gynecology will be developed to achieve the broad goal of effective recognition and management of E/O exposures and disease. An intensive evaluation program is planned to facilitate effective and lasting curriculum change.